Tuesday, November 23, 2010

Drinking And Driving: 20 Years In Retrospect

<a href='http://keep-health-work.blogspot.com/' target='_blank' class='infotextkey'>Health</a> in 30

A gripping piece by the Transport Accident Commission (TAC) in Victoria about?? drinking and driving and the use of illicit drugs. Words cannot depict this powerful and graphic piece. Take a look:


TAC Campaign: 20-Year Anniversary Retrospective Montage a??Everybody Hurtsa??


a??On December 10, 1989 the first TAC commercial went to air.??That year the road toll was 776. Twenty years on it has fallen to 303.??There is still a long way to go.a??



You’ll find more TAC Victoria videos HERE.


Your turn


We would love to hear from you.??Did this video move you in any way???Did it increase your awareness? We would love for you to share your insightful thoughts. As always, thank you for your time.



                       

Monitor Your Heart Rate With Your iPhone Headphones

iMedicalApps


Imagine jogging, listening to music, and being able to keep track of your heart rate without needing a special watch or chest belt — common forms of attempting to monitor heart rates while jogging. Now, imagine not requiring any extra peripherals at all — just your iPhone and a special set of headphones that can monitor your heart rate.


Swiss technology-transfer company CSEM has created the final prototype for their Pulsear device. Ita??s a tiny device embedded in a regular earphone and it sends infrared signals through the tissues in your ear to see how fast your heart is beating. A photo diode records the results and sends the information to your phone via the earphone wires.


Accuracy is paramount. The special earphones had to pass through the scrutiny of the European Space Agency (ESA), who they were originally designed for. The ESA wanted a non-obtrusive device for recording physiological data of astronauts. The resulting research was used to make the prototype device that can be connected to the iPhone and then data recorded using an app. Researchers are now working on giving the earphones the ability to measure O2 levels as well.


Their goal is to create a device that is non-obtrusive and can passively measure vital signs in real time via mobile form.??The vital sign recording earphones will be marketed not only for medical research, but for runners and hikers as well.


How accurate the device is will determine ita??s use and based on the device passing the ESAa??s standards, it seems this is of no concern.??These types of earphones would be a huge hit??commercially??since the two main methods used for tracking heart rate while jogging are with a chest strap or by a watch — both not ideal. The chest strap is accurate, but cumbersome, while watches can often not be as accurate.


From a research perspective, if the creators are able to add the ability to measure pulse ox,the device would have huge research implications. Adding the ability to measure o2 levels shouldna??t be difficult since similar infrared signal technology is used.??The ability to take measures of pulse ox and heart rate in real time and passively would be huge for those with respiratory issues or if researching pulmonary pharmacotherapies.


Source: European Space Agency



                       

Saturday, November 20, 2010

Sharing Your Health Issues: The Responsibility Of Survivorship

Andrew's Blog

Jill ClayburghThis past weekend Oscar-nominated Hollywood and Broadway actress Jill Clayburgh died at age 66. The cause was chronic lymphocytic leukemia (CLL), which she had been fighting, privately, for 21 years.


As you may recall, I, too, have CLL and I was diagnosed at the same age, 45. For me, I am 16 and a half years into that a??battlea?? although, fortunately, I have been feeling very good in the ten years since I received treatment as part of a breakthrough clinical trial. While I have no symptoms and take no medicine I do not consider myself cured.


So when someone like Ms. Clayburgh dies of CLL after 21 years, I cana??t help but wonder if the disease will shorten my life too, even if I feel good now. That brings up the question of what do we do with the time we have when we know we have had a serious diagnosis and the clock may be ticking for us — or not?


In the notice of Ms. Clayburgha??s death it said she dealt with the disease privately. In my case, if you have ever come across my writings or interviews before you know I take the opposite approach. I am VERY public about my health in an effort to mentor others. I actually see it as my responsibility.


No one wants a serious diagnosis. But if you can beat it, or perhaps in my case, beat it back, can your reprieve or cure give you the chance to inspire others and to bring them helpful information? And if you are a celebrity is that part of the job? Some of it can be just with your actions. Patrick Swayze did that by starring in a television series even in his final days with pancreatic cancer. But, sadly, some other celebrities have used their illness or even a distant relativea??s as a way to make more money. These are not the actors who appear for a charity. These are usually the celebrities in medical product commercials.


On the one hand, I am glad they have a??gone public.a?? On the other, I think the effort should be selfless.


But you dona??t have to be a celebrity to make a difference by speaking out. For example, if someone is diagnosed with colon cancer, cana??t they make a difference by urging their friends to be screened. Now, with the latest news about the benefit of CT scans to detect early lung cancer, our biggest cancer killer and our second biggest killer overall (after heart disease), could a lung cancer survivor or family member of a current or former patient urge current or former heavy smokers to be screened? This could easily save a life.


Personally, I am very glad people are more apt these days to share their health issues. It is much less private than it used to be. However, I believe that sharing can be more for a purpose — to inform, inspire and empower others. I respect that Ms. Clayburgh didna??t feel comfortable doing that, as best we know. I wish she had, because in CLL, just the fact that she had continued acting would have given comfort to many people I know who are stopped in their tracks by the diagnosis.


So do we patients have a responsibility to others? I say, “yes.” What do you say?


By the way, I now have hosted more than 2,000 interview programs. You can find them by going to any search engine and typing in your health topic + patient power. Tell a friend!


Wishing you and your family the best of health,


Andrew



                       

Male Laptop Users: Beware Of An Overheated “Lap”

Medgadget

83kdkjj.jpgMale readers be advised! Using your laptop placed on your knees to read this post may cause your testicles to heat up quite significantly. However surprisingly, this is not due to the heat dissipated by many laptops, but rather due to the positioning of the legs. A study just published online in the journal Fertility and Sterility investigated ways to avoid the testicles from overheating while using a laptop computer.


Right and left scrotal temperatures were measured in 29 volunteers while working on the laptop in different positions: With closely approximated legs, with closely approximated legs with a lap pad below the laptop, and sitting with legs apart at a 70?° angle with a lap pad below the laptop. After 60 minutes with closed legs, temperature increased about 2.4 degrees Celsius, using the lap pad yielded a slightly smaller increase of 2.1 degrees, while spreading the legs resulted in a modest increase of 1.4 degrees.


The authors conclude that prevention of scrotal hyperthermia in laptop users is not feasible, although we would like to disagree and suggest using a flat surface, such as a table or desk, to position your laptop in order to preserve your fertility.


Article abstract: Protection from scrotal hyperthermia in laptop computer users…


Image credit: Pitel…



                       

5 Tips On How To Be A Healthcare Survivalist

See First Blog

There are plenty of a??survivalistsa?? out there who stock their basements with canned goods, getting ready for some unexpected (and unlikely) apocalypse. Meanwhile there are things that are much more likely to happen to you — like getting sick — which many of us dona??t prepare for at all. So to help you get started, here are five important tips on how you can become a healthcare survivalist:


1.?? Take care of your chronic conditions. Whether ita??s high blood pressure, diabetes, high cholesterol, depression, asthma or any other kind of ailment, do what it takes to manage your own care.??Take your medications and follow your doctorsa?? instructions.??Why? Because if you dona??t, your condition can get worse and lead to even more serious problems.??As much of a pain as it may (literally) be, therea??s a reason the old saying a??an ounce of preventiona?? still resonates today — because ita??s true.


2.?? Live a healthy lifestyle. Everyone gives you this advice, but with studies showing that 42% of Americans will be obese by 2050, it doesna??t seem to be getting through.??Denial can wonderfully appealing;?? but when it comes to your health, it can also kill you.??Stop smoking, exercise, and eat right.??You may find that your employer has programs in place that will help you do all of those things, and many of them work. Why not give one of them a try???You cana??t improve your life all at once, but you can start.??Your life will be happier if you keep yourself healthy.??So rather than whistling past the graveyard, jog past it.


3. Make sure you are well-insured. You may not have the greatest insurance plan through your job, but there are things you can do to protect yourself on your own. For example, most insurance doesna??t pay the full cost of long term care.??This is the kind of care you might need if you end up needing home nursing care or have to live in an assisted living facility.??That can be very costly.??You should buy long-term care insurance to cover these expenses and serve as a cornerstone of your health care survival plan.??Studies show that 60% of seniors will need long-term care at some point in their lives — and Medicare doesna??t cover it.??Oh, and ita??s not just a problem of the elderly.??About 40% of people getting long-term care are between 18 and 64.


There are other kinds of insurance you can buy, too, depending on the state in which you live.??These might be plans that supplement your health coverage, or cover other expenses of illness.??The best advice:?? Research your options, find an insurance broker you trust, and figure out a plan that helps protect you from the financial toll of illness.??Also keep in mind that your employer may offer, on a voluntary basis, a number of these kinds of programs at cheap prices — check them out and see if they make sense for you.


4.?? Know your family history. Ita??s a little hard to believe in the 21st century, but it turns out that an old-fashioned knowledge of your familya??s medical history can be some of your best protection.??It can help your doctor know whether you have a higher risk for certain illnesses.??And it can also help him or her know whether that symptom youa??re complaining about is a sign of something other than what it seems to be.??A surprising study recently showed that a family history can be better than even genetic testing at predicting your likelihood of disease.????The Surgeon General has a neat tool that can help you get started. The more you know about your familya??s medical past, the better off you and your doctors will be in your medical future.


5.?? Ask Questions. No matter how well you prepare and try to protect yourself, at some point you may still end up seriously ill. Hopefully, if youa??ve taken good care of yourself and have all of your information in order, youa??ve put yourself in the best position to make it through.??But therea??s still so much more you can and should do.??The world is full of well-intentioned, highly skilled, and hardworking doctors.??The trouble is, they work in a system that makes it very difficult for them to do their jobs.??So, ask questions, and use every resource available to you to make sure youa??re getting the right medical care.



                       

HRT And Breast Cancer: The Confusion And Debate Continue

tbtam



A new analysis of long-term data from the Womena??s Health Initiative confirms what we already knew the first time around: Use of combination hormone replacement (HRT*) is associated with a small, but real, risk of breast cancer. This new 11-year followup data carries that knowledge out to its not unexpected conclusion — namely, that some (although not most) breast cancers can be fatal, and therefore the the use of HRT can increase breast cancer mortality.


While it may seem a bit of a a??duh,a?? this study was, in fact, necessary to quell the WHI critics who continued to argue that the breast cancers caused by HRT were somehow less aggressive than those occurring off HRT (which they are not.) It was also a wake-up call for many women who were continuing to use HRT and thinking that somehow its risks did not apply to them. A fair number of these women appear to be coming off of HRT, at least in my practice. Others are staying the course and accepting the risks as they have been defined. Either of which is fine with me.


The spin going on around this study — both for and against HRT use — is tremendous and ultimately confusing to women. The pro-HRT crowd (some of whom have relationships to Pharma) is using language like: a??The increased risk from using HRT for??five years is the same as if your menopause occurred??five years later,a?? which is technically true, but so what? ??The bioidentical hormone crowd (usually also selling the same) are using the study to further hype how their regimens are safer than the evil Big Pharma products — based on no data. Which leaves the rest of us to try to find ways to help our patients understand the risks, place them into perspective for themselves, and make a decision about how and if to treat their menopausal symptoms.


While the breast cancer risks associated with HRT use appear to be quite real, for a individual woman they are not that large. Herea??s how I explain the risks to my patients:


There will be??seven extra cases of breast cancer and 1.3 additional breast cancer deaths for every 10,000 women per year who use??HRT. Said another way, if you use HRT for 20 years, your risk of getting breast cancer will be increased by 1.4??percent??and your chance of dying from breast cancer will be increased by about a quarter of a percent. If you use HRT for less than 20 years, we can cut those numbers down accordingly.**


If you dona??t already know it, I do have??my own set of??rules for prescribing HRT. This??new data has not changed them.


_______________________________________________________________


* HRT means estrogen and progesterone taken together, as opposed to ERT, or estrogen alone. In the WHI, ERT use was actually associated with a lower rate of breast cancer, a finding unique to this study that begs for replication before we can bless ERT as breast-safe.


** The formula I used for cumulative risk is CR = 1 a?? e-IR*t ,where CR = cumulative risk, IR is the annual incidence and t is the number of years (in this case 20). If any statistician types reading this can confirm my methodology or numbers Ia??d appreciate it.


Graph above from JAMA. 2010;304(15):1684-1692.



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Friday, November 19, 2010

Heart Smarts

Andrew's Blog

From the American Heart Association’s “Scientific Sessions 2010” in Chicago (November 13-17):



Chicago Heart Smarts from Patient Power?? on Vimeo.



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